| NPI | 1043519515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 276487) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 125059231) |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2021-04-07 |